European Radiology最新文献

{"title":"A head-to-head comparison of breast lesion's conspicuity at contrast-enhanced mammography and contrast-enhanced MRI.","authors":"Ambra Santonocito, Calogero Zarcaro, Layla Zeitouni, Francesca Ferrara, Panagiotis Kapetas, Thomas H Helbich, Paola Clauser, Pascal A T Baltzer","doi":"10.1007/s00330-024-11195-4","DOIUrl":"10.1007/s00330-024-11195-4","url":null,"abstract":"<p><strong>Purpose: </strong>Lesion conspicuity, the relative enhancement of a lesion compared to surrounding tissue, is a new descriptor in the ACR BI-RADS 2022 CEM supplement. We compared lesion conspicuity in contrast-enhanced mammography (CEM) and contrast-enhanced MRI (CE-MRI) in patients with suspicious breast lesions.</p><p><strong>Materials and methods: </strong>IRB-approved retrospective study; three blinded readers rated 462 indeterminate or suspicious breast lesions in 388 patients (54.2 ± 11 years; range 30-90) who underwent CEM and CE-MRI from 2018 to 2022. Each lesion's conspicuity was scored from 1 to 5, with 5 indicating excellent conspicuity. Visual grading characteristics (VGC) analysis and area under the curve (AUC) were used for comparison, with sub-analyses for benign and malignant lesions.</p><p><strong>Results: </strong>VGC analysis showed a significant AUC of 0.670 to 0.723 (p < 0.001) favouring CE-MRI. No lesion enhancement (score 1) was observed in 16.2% of CE-MRI and 44.7% of CEM. Excellent conspicuity was seen in 29.6% of CE-MRI and 11.9% of CEM. Sub-analysis showed higher conspicuity on CE-MRI for both malignant (AUC 0.665 to 0.732, p < 0.001) and benign lesions (AUC 0.734 to 0.798, p < 0.001). CE-MRI showed higher lesion conspicuity compared to CEM both for non-mass lesions (0.656) and for mass lesions 0.605.</p><p><strong>Conclusion: </strong>CE-MRI shows significantly higher conspicuity for benign and malignant breast lesions compared to CEM, especially for benign lesions. The low conspicuity of benign lesions on CEM may help reduce false positives in clinical practice.</p><p><strong>Key points: </strong>Question Lesion conspicuity is a new descriptor for lesion enhancement according to the new CEM lexicon. Data correlating lesion conspicuity with malignancy likelihood are limited. Findings Lesion conspicuity is higher for contrast-enhanced-MRI than for contrast-enhanced mammography (CEM) for all lesions but significantly better for benign lesions. Clinical relevance The low conspicuity of benign lesions on CEM may reduce false-positive results, making it a valuable tool in breast cancer screening.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3070-3079"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetization-transfer flow-independent dark-blood delayed enhancement cardiac MRI optimizes discrimination of ST-elevation myocardial infarct borders.","authors":"Paulina Poskaite, Christian Kremser, Mathias Pamminger, Felix Troger, Gert Reiter, Sebastian J Reinstadler, Bernhard Metzler, Wolfgang G Rehwald, Raymond J Kim, Agnes Mayr","doi":"10.1007/s00330-024-11192-7","DOIUrl":"10.1007/s00330-024-11192-7","url":null,"abstract":"<p><strong>Objectives: </strong>To prospectively compare image quality and infarct sizing methods between magnetization-transfer \"flow-independent dark-blood delayed enhancement\" (MT-FIDDLE) and standard \"bright-blood\"-late gadolinium enhancement (LGE) cardiac-magnetic-resonance (CMR) sequence.</p><p><strong>Methods: </strong>\"Bright-blood\"-LGE and MT-FIDDLE sequence were acquired in 110 patients at 4 days (n = 33), 4 months (n = 39) and 12 months (n = 38) after acute ST-elevation myocardial infarction (STEMI). Subjective image quality, including confidence in infarct segmentation and blood-pool bordering, were each rated on a 4-point Likert scale. Objective image quality was assessed by the detectability index (DI). Infarct volumes derived via full-width at half-maximum (FWHM) and different number of standard deviations (\"n-SD\") methods on MT-FIDDLE images were compared with FWHM and reference 5-SD results from \"bright-blood-LGE images.</p><p><strong>Results: </strong>Overall subjective median image quality was excellent for both LGE sequences. Qualitative analysis revealed a significantly higher confidence in infarct segmentation and in blood-pool bordering for MT-FIDDLE as compared to \"bright-blood\"-LGE (all p < 0.001). Infarct volumes assessed by the FWHM technique on MT-FIDDLE and \"bright-blood\"-LGE showed excellent agreement overall (Concordance correlation coefficient, CCC = 0.96). The 3-SD technique for MT-FIDDLE showed the best agreement with the 5-SD method for \"bright-blood\"-LGE overall (CCC = 0.94), as well as in the subgroup with excellent confidence in infarct segmentation on \"bright-blood\"-LGE (CCC = 0.96). DI of scar versus LV blood-pool was higher for MT-FIDDLE (8.9 ± 5.5) compared to \"bright-blood\"-LGE sequence (2.0 ± 1.5; p < 0.001).</p><p><strong>Conclusion: </strong>MT-FIDDLE significantly optimizes the discrimination between myocardial infarction and adjacent blood-pool in STEMI patients. As compared to the established 5-SD technique on \"bright-blood\"-LGE, the 3-SD method on MT-FIDDLE results in consistent infarct volumes.</p><p><strong>Key points: </strong>Question Does magnetization-transfer \"flow-independent dark-blood delayed enhancement\" (MT-FIDDLE) offer any benefits over standard \"bright-blood\"-late gadolinium enhancement (LGE) cardiac-magnetic-resonance (CMR) for identifying STEMI infarct borders? Findings MT-FIDDLE image quality was higher than LGE CMR and measured infarct volume comparability to the standard 5-SD-threshold-technique. Clinical relevance MT-FIDDLE facilitates the assessment of myocardial infarctions at the subendocardial border, improving the discrimination between myocardial infarction and adjacent blood-pool in STEMI patients.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3030-3041"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-high-resolution 40 keV virtual monoenergetic imaging using spectral photon-counting CT in high-risk patients for coronary stenoses.","authors":"Guillaume Fahrni, Sara Boccalini, Hugo Lacombe, Fabien de Oliveira, Angèle Houmeau, Florie Francart, Marjorie Villien, David C Rotzinger, Antoine Robert, Philippe Douek, Salim A Si-Mohamed","doi":"10.1007/s00330-024-11237-x","DOIUrl":"10.1007/s00330-024-11237-x","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the image quality of ultra-high-resolution (UHR) virtual monoenergetic images (VMIs) at 40 keV compared to 70 keV, using spectral photon-counting CT (SPCCT) and dual-layer dual-energy CT (DECT) for coronary computed tomography angiography (CCTA).</p><p><strong>Methods and materials: </strong>In this prospective IRB-approved study, 26 high-risk patients were included. CCTA was performed both with an SPCCT in UHR mode and with one of two DECT scanners (iQOn or CT7500) within 3 days. 40 keV and 70 keV VMIs were reconstructed for both modalities. Stenoses, blooming artefacts, and image quality were compared between all four reconstructions.</p><p><strong>Results: </strong>Twenty-six patients (4 women [15%]) and 28 coronary stenoses (mean stenosis of 56% ± 16%) were included. 40 keV SPCCT gave an overall higher quality score (5 [5, 5]) than 70 keV SPCCT (5 [4, 5], 40 keV DECT (4 [3, 4]) and 70 keV SPCCT (4 [4, 5]), p < 0.001). Less variability in stenosis measurement was found with SPCCT between 40 keV and 70 keV (bias: -1% ± 3%, LoA: 6%) compared with DECT (-6% ± 8%, LoA 16%). 40 keV SPCCT vs 40 keV DECT showed a -3% ± 6% bias, whereas 40 keV SPCCT vs 70 keV DECT showed a -8% ± 6% bias. From 70 keV to 40 keV, blooming artefacts did not increase with SPCCT (mean +2% ± 5%, p = 0.136) whereas they increased with DECT (mean +7% ± 6%, p = 0.005).</p><p><strong>Conclusion: </strong>UHR 40 keV SPCCT VMIs outperformed 40 keV and 70 keV DECT VMIs for assessing coronary artery stenoses, with no impairment compared to 70 keV SPCCT VMIs.</p><p><strong>Key points: </strong>Question Use of low virtual mono-energetic images at 40 keV using spectral dual-energy and photon-counting CT systems is not yet established for diagnosing coronary artery stenosis. Findings UHR 40 keV SPCCT enhances diagnostic accuracy in coronary artery assessment. Clinical relevance By combining spectral sensitivity with lower virtual mono-energetic imaging and ultra-high spatial resolution, SPCCT enhances coronary artery assessment, potentially leading to more accurate diagnoses and better patient outcomes in cardiovascular imaging.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3042-3053"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical applications of dual-layer spectral detector CT in digestive system diseases.","authors":"Yidi Chen, Xijiao Liu, Hanjiang Zeng, Jinge Zhang, Zhengyan Li, Bin Wu, Zixing Huang, Bin Song","doi":"10.1007/s00330-024-11290-6","DOIUrl":"10.1007/s00330-024-11290-6","url":null,"abstract":"<p><strong>Objective: </strong>Dual-layer spectral detector CT (DLCT) has several advantages in clinical practice, this study aims to reveal the clinical applications of DLCT in digestive system diseases.</p><p><strong>Materials and methods: </strong>We searched PubMed and Cochrane Reviews for articles published from January 1, 2010 to May 31, 2024, using the terms \"dual-layer spectral detector CT\" or \"dual-layer CT\" combined with \"hepatic fat\" or \"hepatic fibrosis\" \"hepatocellular carcinoma\" or \"pancreatic ductal adenocarcinoma\" or \"pancreatic neuroendocrine tumors\" or \"gastric cancer\" or \"colorectal cancer\" or \"Crohn's disease\" or \"bowel ischemia\" or \"acute abdominal conditions\".</p><p><strong>Results: </strong>DLCT consists of a top layer sensitive to lower-energy photons and a bottom layer sensitive to higher-energy photons. This configuration enables simultaneous acquisition of two energy spectra from a single X-ray beam ensuring consistent spatial alignment and temporal resolution. Spectral raw images allow image post-processing to improve image quality, reduce radiation doses and contrast media doses, and generate multiple quantitative parameters. It has broad potential for early detection, accurate staging, efficacy assessment, and prognosis prediction of liver, pancreatic, and gastrointestinal diseases, as well as for the assessment of digestive system vasculature.</p><p><strong>Conclusions: </strong>DLCT not only provides valuable information for the clinical diagnosis and therapeutic effect evaluation of digestive system diseases but also may play a more important role in the overall management of digestive diseases and in the decision-making of individualized medicine.</p><p><strong>Key points: </strong>Question What are the advantages of DLCT compared to traditional single-energy CT in the early detection, staging, and therapeutic evaluation of digestive system diseases? Findings DLCT enhances image quality, improves tissue characterization, and allows for multi-parametric analysis, making it superior in detecting and evaluating liver, pancreatic, and gastrointestinal diseases. Clinical relevance DLCT provides high-quality, multi-parametric imaging that improves the accuracy of diagnosing digestive diseases, facilitates more precise treatment planning, and enhances monitoring of treatment response, ultimately contributing to better patient management and prognosis.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3547-3557"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prognostic value of pretreatment [¹⁸F]FDG PET/CT parameters in esophageal cancer: a meta-analysis.","authors":"Mingxing Huang, Weichen Wang, Rang Wang, Rong Tian","doi":"10.1007/s00330-024-11207-3","DOIUrl":"10.1007/s00330-024-11207-3","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the prognostic implications of pretreatment [¹⁸F]FDG-PET metrics in esophageal cancer patients through a meta-analysis of the existing literature.</p><p><strong>Methods: </strong>We carefully searched electronic databases, including PubMed and Embase, from inception to April 1, 2024, to identify studies describing the prognostic value of pretreatment PET metrics for advanced esophageal cancer. Clinical endpoints examined were overall survival (OS), recurrence-free survival (RFS)/disease-free survival (DFS), and progression-free survival (PFS). Hazard ratios (HRs) for PFS and OS were taken directly from the original reports.</p><p><strong>Results: </strong>Forty-seven publications, including 5504 patients, were included in our analysis. OS and PFS were analyzed in 31 and nine studies, respectively, and DFS/RFS was analyzed in 16 studies. The comprehensive pooled analysis revealed significant associations between metabolic parameters derived from positron emission tomography (PET) imaging and clinical outcomes. Expressly, the pooled HR indicated that patients with higher SUVmax were significantly associated with poor PFS (HR: 1.06; 95% CI: 1.01-1.12, p = 0.011) and poor RFS/DFS (HR: 1.09; 95% CI: 1.02-1.18, p = 0.019). Patients with higher SUVmean were significantly associated with poorer OS (HR: 1.07; 95% CI: 1.01-1.14, p = 0.025). High MTV was significantly associated with inferior OS (HR: 1.02; 95% CI: 1.00-1.05, p = 0.049). High TLG was significantly associated with poorer RFS/DFS (HR: 2.02; 95% CI: 1.11-3.68, p = 0.022).</p><p><strong>Conclusion: </strong>This study unveiled pretreatment FDG-derived parameters as valuable prognostic indicators in assessing esophageal cancer outcomes. Specifically, SUVmax is associated with PFS and RFS/DFS. SUVmean and MTV were correlated with OS, and TLG was only associated with RFS/DFS.</p><p><strong>Key points: </strong>Question Inconsistent findings on the prognostic value of pretreatment [¹⁸F]FDG PET parameters in esophageal cancer require comprehensive analysis to clarify their role in outcome prediction. Findings Higher pretreatment [¹⁸F]FDG-PET metrics (SUVmax, SUVmean, MTV, TLG) are associated with poor survival outcomes, emphasizing their potential value in enhancing prognostic assessments for esophageal cancer. Clinical relevance This study highlights the prognostic significance of pretreatment [¹⁸F]FDG-PET metrics in esophageal cancer, providing valuable insights for patient outcome prediction and potentially guiding personalized treatment strategies.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3396-3408"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suppression of immobilisation device on wrist radiography to improve fracture visualisation.","authors":"Sungwon Lee, Keum San Chun, Seungeun Lee, Hyemin Park, Tuan Dinh Le, Joon-Yong Jung","doi":"10.1007/s00330-024-11232-2","DOIUrl":"10.1007/s00330-024-11232-2","url":null,"abstract":"<p><strong>Objectives: </strong>This study validates the use of CycleGAN-generated wrist radiographs with digitally removed splints, specifically assessing their impact on fracture visualisation.</p><p><strong>Materials and methods: </strong>We retrospectively collected wrist radiographs from 1748 patients who had imaging before and after splint application at a single institution. The dataset was divided into training (1696 patients, 5353 images) and testing sets (52 patients, 965 images). A CycleGAN-based model was trained to generate splint-free wrist radiographs (generated \"splint-less\") from the original \"splint\" images. A pre-trained fracture detection model (YOLO8s) was used to assess fracture detection performance on three image groups: original \"splint-less\" radiographs, original \"splint\" radiographs, and generated \"splint-less\" radiographs. Two radiologists scored the generated images. Subtraction images quantified overall image alterations. Precision, recall, and F1 scores were used to compare fracture detection performance.</p><p><strong>Results: </strong>CycleGAN effectively generated splint-suppressed radiographs with minimal remaining splint density (< 10% remaining in 97.99%), hardware distortion (< 10% change in 100%), anatomical distortion (< 10% in 99.63%), and fracture lesion changes (< 10% change in 100%). New artefacts were rare (absent in 97.54%). Notably, the fracture detection model achieved higher precision (0.94 vs. 0.92), recall (0.63 vs. 0.5), and F1 score (0.75 vs. 0.65) on the generated \"splint-less\" radiographs compared to the original \"splint\" radiographs, approaching the performance on original \"splint-less\" radiographs (F1 0.71). Furthermore, greater image alterations by CycleGAN correlated with larger improvements in fracture detection.</p><p><strong>Conclusion: </strong>CycleGAN successfully removed splint densities from wrist radiographs with splints.</p><p><strong>Key points: </strong>Question Can CycleGAN (Generative Adversarial Networks), designed for image-to-image translation, generate synthetic \"splint-less\" radiographs to improve fracture visualisation in follow-up radiographs? Findings Removal of splint densities from wrist radiographs using Generative Adversarial Networks preserved anatomical structures and improved the performance of a fracture detection model. Clinical relevance Generated splint-less radiographs can enhance the performance of wrist fracture detection in wrist radiographs, benefiting both human clinicians and AI-powered diagnostic tools.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3418-3428"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of abbreviated and complete MRI protocols for treatment response assessment of colorectal liver metastases.","authors":"Maria El Homsi, Jad Bou Ayache, Maria Clara Fernandes, Natally Horvat, Tae Hyung Kim, Maria LaGratta, Galina Levin, Ally Rosen, Natalie Gangai, Stephanie Lobaugh, Junting Zheng, Marinela Capanu, Richard Kinh Gian Do","doi":"10.1007/s00330-024-11277-3","DOIUrl":"10.1007/s00330-024-11277-3","url":null,"abstract":"<p><strong>Objective: </strong>To compare abbreviated magnetic resonance imaging (MRI) to complete MRI for treatment response assessment of colorectal liver metastases.</p><p><strong>Material and methods: </strong>This retrospective study included consecutive patients with colorectal liver metastases between January 1, 2012, and December 3, 2021, who were undergoing chemotherapy and who had at least one follow-up gadoxetic-enhanced MRI. For each patient, two MRIs (baseline MRI and follow-up MRI) were randomly selected. Follow-up MRIs were separated into two sets of images: complete MRIs, including all imaging sequences, and abbreviated MRIs, including coronal and axial hepatobiliary phase imaging, axial diffusion-weighted imaging, and coronal T2-weighted imaging. Seven radiologists reviewed the two sets of images, with a month's break in between, assessing Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 category and the presence of new lesions, with each reader assigned 80-91 patients. Inter-reader agreement was assessed using Fleiss' kappa (κ).</p><p><strong>Results: </strong>One-hundred ninety-five patients (mean age 54.4 +/- 12.1 years, 135 men) were evaluated. Intra-reader agreement between abbreviated and complete MRI was substantial for the RECIST 1.1 category (κ, 0.66-0.89) and the detection of new lesions (κ, 0.63-0.81). Inter-reader agreement was substantial for RECIST 1.1 category using abbreviated MRI and complete MRI (κ, 0.71 (95% CI: 0.65-0.78) and 0.68 (95% CI: 0.61-0.75)), and moderate for the presence of new lesions using abbreviated MRI and complete MRI (κ, 0.56 (95% CI: 0.41-0.69) and 0.49 (95% CI: 0.35-0.65)).</p><p><strong>Conclusion: </strong>Abbreviated MRI may serve as an alternative to complete MRI for the follow-up of patients with colorectal liver metastases.</p><p><strong>Key points: </strong>Question Abbreviated MRI is a time-saving and cost-effective exam, but only one study has compared it with complete MRI for treatment response assessment of colorectal liver metastases. Findings In our study, abbreviated follow-up MRI achieved substantial inter-reader agreement for the RECIST 1.1 category and moderate inter-reader agreement for the presence of new lesions. Clinical relevance Abbreviated liver MRIs are adequate substitutes for complete liver MRIs for colorectal liver metastases in the follow-up setting when the goal is to assess treatment response, resulting in shorter examination times and potential reductions in costs.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3450-3459"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual-energy CT for differentiation of hypodense liver lesions in pancreatic adenocarcinoma.","authors":"Corey T Jensen, Vincenzo K Wong, Gauruv S Likhari, Taher E Daoud, Moiz Ahmad, Roland Bassett, Sarah Pasyar, Mayur K Virarkar, Alicia M Roman-Colon, Xinming Liu","doi":"10.1007/s00330-024-11291-5","DOIUrl":"10.1007/s00330-024-11291-5","url":null,"abstract":"<p><strong>Objective: </strong>To assess the accuracy of CT spectral HU curve assessment of hypodense liver lesions.</p><p><strong>Methods: </strong>In this retrospective HIPAA-compliant study (January 2016 through May 2023), patients with biopsy-proven pancreatic adenocarcinoma and a biopsied indeterminate liver lesion underwent a DECT abdominal CT scan. Spectral HU curves were provided for each hypodense liver lesion, and slopes were calculated. Lesion Hounsfield units, iodine concentration and virtual enhancement were recorded. The Wilcoxon rank sum test was used to compare malignant and benign lesions. Optimal cutoff points were estimated using ROC curves and Youden's Index.</p><p><strong>Results: </strong>Thirty-six patients (19 men, 17 women) with a mean age of 63 years ± 9 (standard deviation), a mean height of 170.9 cm ± 9.5, a mean weight of 69.8 kg ± 14.5, and a body mass index of 23.9 kg/m² ± 3.5. Reference standard assessment identified 92 liver lesions (50 metastases, 24 cysts, 13 abscesses, 3 regions of inflammation, 2 hemangiomas) with a mean size of 1.1 cm ± 0.5. The mean interval between the CT and liver lesion biopsy was 24 days. A diagnosis of benign versus malignant was determined based on optimal cutoffs: spectral curve slope of 1.36, iodine concentration of 6.47 (100 µg/cm³), and enhancement of 10.25. The receiver operating curves (ROC) for diagnosis using spectral curve slope, iodine concentration, and virtual enhancement resulted in an area under the curve (AUC) of 0.948, 0.946, and 0.937, respectively.</p><p><strong>Conclusion: </strong>Spectral HU curves and iodine concentration of well-defined hypodense liver lesions are highly accurate in the diagnosis of benign versus malignant lesions.</p><p><strong>Key points: </strong>Question Limited evidence exists for spectral imaging diagnosis of liver lesions-can DECT accurately differentiate between benign and metastatic hypodense liver lesions? Findings Ninety-two hypodense liver lesions evaluated using HU keV curve slope, iodine concentration, and virtual enhancement resulted in accurate benign versus metastatic differentiation. Clinical relevance Hypodense liver lesions are a challenging issue at staging, often requiring further imaging, follow-up, and/or biopsy. The additional information from multi-energy CT can be useful to differentiate between benign and malignant lesions, thereby reducing the need for costly additional evaluation.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3538-3546"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Super delayed phase imaging in gadoxetic acid-enhanced MRI: investigating factors contributing to improved liver contrast.","authors":"Tomohiro Kobayashi, Kazuto Kozaka, Takashi Matsubara, Akira Yokka, Saya Igarashi, Azusa Kitao, Norihide Yoneda, Miho Okuda, Toshifumi Gabata, Osamu Matsui, Satoshi Kobayashi","doi":"10.1007/s00330-024-11227-z","DOIUrl":"10.1007/s00330-024-11227-z","url":null,"abstract":"<p><strong>Objectives: </strong>To assess whether extended delayed phase imaging, performed after gadoxetic acid administration for 60-120 min (termed as super delayed phase [SDP]), improves liver contrast and nodule visibility in patients with chronic liver disease and to identify predictors for contrast enhancement.</p><p><strong>Methods: </strong>In this retrospective study, 116 patients with chronic liver disease were selected from 6933 gadoxetic acid-enhanced MRI examinations, which included SDP images. The liver-to-spleen contrast (LSC) was quantitatively evaluated, and factors influencing the improvement of LSC were analyzed. By comparing the standard hepatobiliary phase images at 20 min post-contrast (HBP20) with SDP images, nodule visibility was evaluated by two readers who were blinded to the study.</p><p><strong>Results: </strong>SDP significantly enhanced LSC (SDP: 1.81 ± 0.48 vs HBP20: 1.50 ± 0.34, p < 0.001) and improved nodule visibility in patients with initially poor LSC. Total bilirubin levels and visible biliary excretion during HBP20 are predictors of LSC enhancement. Furthermore, nodule visibility scores significantly increased in the group with poor initial contrast (Reader 1: from 2.92 ± 1.57 to 3.79 ± 1.44; Reader 2: from 2.34 ± 1.42 to 3.36 ± 1.57, p < 0.001).</p><p><strong>Conclusion: </strong>SDP enhanced liver contrast and nodule detection in patients with chronic liver disease, particularly in those with impaired liver function. Total bilirubin levels and visible biliary excretion during HBP20 are useful predictors of improvement. This technique may improve the diagnostic utility of MRI for hepatocarcinogenesis in cirrhotic nodules, specifically for detecting precursors of hepatocellular carcinoma, in cirrhotic patients with compromised liver function.</p><p><strong>Key points: </strong>Question In gadoxetic acid-enhanced MRI, inadequate liver contrast can occur in patients with impaired liver function, potentially limiting the diagnostic value of the examination. Findings SDP images improved liver parenchymal signal intensity and visibility of hepatocellular carcinoma, even in cases with impaired liver function. Clinical relevance The addition of SDP imaging in gadoxetic acid-enhanced MRI improves liver contrast and early detection of hepatocellular carcinoma, especially in patients with impaired liver function, such as Child-Pugh B or C, aiding in making appropriate treatment decisions.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3195-3205"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ESSD-ESGAR best practice position statements on the technical performance of videofluoroscopic swallowing studies in adult patients with swallowing disorders.","authors":"Martina Scharitzer, Wolfgang Schima, Margaret Walshe, Eric Verin, Stefano Doratiotto, Olle Ekberg, Daniele Farneti, Peter Pokieser, Emilio Quaia, Virginie Woisard, Ekaterini Xinou, Renée Speyer","doi":"10.1007/s00330-024-11241-1","DOIUrl":"10.1007/s00330-024-11241-1","url":null,"abstract":"<p><strong>Objectives: </strong>Videofluoroscopic swallowing studies (VFSS) remain the gold standard for the instrumental assessment of oropharyngeal swallowing disorders alongside flexible endoscopic evaluation of swallowing (FEES), requiring a high standard of quality and correct implementation. The current best practice position statements aim to guide the clinical practice of VFSS in individuals experiencing swallowing disorders.</p><p><strong>Materials and methods: </strong>An international expert consensus panel with expertise in oropharyngeal dysphagia, comprised of radiologists, speech-language therapists, otolaryngologists, and other professionals in the field, convened by the European Society of Swallowing Disorders (ESSD) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), developed best practice position statements. They were established using an online Delphi methodology involving an online panel discussion and item preparation and three consecutive rounds. Consensus was reached when ≥ 80% of the participants agreed on a specific recommendation.</p><p><strong>Results: </strong>Eighteen best practice position statements were formulated, thereby establishing standard recommendations on the technical performance of VFSS. They cover VFSS planning, correct implementation, documentation, radiation protection, equipment and maintenance, and education and training.</p><p><strong>Conclusion: </strong>These position statements summarise the panel's deliberations and recommendations in performing VFSS, representing the agreed consensus of experts from ESSD and ESGAR. They provide a structured framework for optimising and standardising the performance of VFSS in patients with swallowing disorders.</p><p><strong>Key points: </strong>Question Significant regional and national differences in clinical practice when performing VFSS highlight the need for interdisciplinary recommendations to optimise patient care. Findings Eighteen statements were developed by representatives of the ESSD and the ESGAR. Clinical relevance These best practice position statements on the technical performance of VFSS may serve as a basis for standardising the procedure and ensuring high-quality service.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3169-3180"},"PeriodicalIF":4.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}